• Surgery · May 2015

    Injury prevalence and causality in developing nations: Results from a countrywide population-based survey in Nepal.

    • Shailvi Gupta, Evan G Wong, Sarthak Nepal, Sunil Shrestha, Adam L Kushner, Benedict C Nwomeh, and Sherry M Wren.
    • University of California San Francisco, East Bay, Oakland, CA; Surgeons Overseas, New York, NY. Electronic address: Shailvi.gupta@gmail.com.
    • Surgery. 2015 May 1;157(5):843-9.

    BackgroundTraumatic injury affects nearly 5.8 million people annually and causes 10% of the world's deaths. In this study we aimed to estimate injury prevalence, to describe risk-factors and mechanisms of injury, and to estimate the number of injury-related deaths in Nepal, a low-income South Asian country.MethodsA cluster randomized, cross-sectional nationwide survey using the Surgeons OverSeas Assessment of Surgical Need tool was conducted in Nepal in 2014. Questions were structured anatomically and designed around a representative spectrum of operative conditions. Two-stage cluster sampling was performed: 15 of 75 districts were chosen randomly proportional to population; within each district, after stratification for urban and rural populations, 3 clusters were randomly chosen. Injury-related results were analyzed.ResultsA total of 1,350 households and 2,695 individuals were surveyed verbally, with a response rate of 97%. A total of 379 injuries were reported in 354 individuals (13.1%, 95% confidence interval 11.9-14.5%), mean age of 32.6. The most common mechanism of injury was falls (37.5%), road traffic injuries (19.8%), and burns (14.2%). The most commonly affected anatomic site was the upper extremity (42.0%). Of the deaths reported in the previous year, 16.3% were injury-related; 10% of total deaths may have been averted with access to operative care.ConclusionThis study provides baseline data on the epidemiology of traumatic injuries in Nepal and is the first household-based countrywide assessment of injuries in Nepal. These data provide valuable information to help advise policymakers and government officials for allocation of resources toward trauma care.Copyright © 2015 Elsevier Inc. All rights reserved.

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